Slipped Disc Arm Pain

Keywords; slipped disc arm pain.

Discomfort radiating from the neck into the limb is common at the chiropractic clinic; but the true prolapse in the spine producing a severe ache and tingling in the upper extremity is fortunately relatively rare.

It's an
extremely nasty condition, and a deep ache spreading from the trapezius down the limb is one of the
noteworthy features; it's often worse at night. If it affects the fifth cervical nerve root, then the symptoms radiate to the mid back between the shoulder blades; to the rhomboid and levator scapular muscles.

There are other conditions that can mimic the injury; there are orthopaedic tests that help us distinguish between them. The aim is to reproduce the ache in the limb, so they need to be done gently; they can aggravate the disease process.

Folk are often afraid of that word; it simply means a lack of ease and could relate just as easily to an ingrowing toenail as cancer of the spine.

Some tests are complex but others, like Spurlings and the Upper Limb Tension stretch, you can do for yourself.

More usually turning towards the side of the ache increases the symptoms; but if the nerve is tethered by a degenerate joint of Luschka then turning in the opposite direction increases the stretch on the root.

It's often provoked by working above your head as in painting the ceiling or replacing a light fitting for example.

ANATOMY OF A DISC

The Intervertebral Disc (= between the vertebrae) is made of two parts.

ANNULUS FIBROSIS ... a very thick tough ligament-like ring of fibres which contains the

The gel is essentially a liquid, and liquids are incompressible. When
the neck is moved the bubble of gel bulges into the surrounding
ring-like annulus which distorts to accommodate the nucleus. That's all
quite normal anatomy.

The annulus fibrosis consists of about six layers, criss-crossed to make a very tough ring to support the nucleus pulposis.

However,
in the slipped disc in neck the gel ruptures through one or more layers
of the annulus fibrosis. Initially there is just pain in the neck, but
the disc will swell and then may cause arm pain.

Slipped Disc Arm Pain

Shoulder Abduction Relief sign.

If the slipped disc has a large bulge then you will often get relief by placing your hand on, or above, your
head; or sleeping with it under your pillow. Raising the limb takes
the stretch off the nerve, reducing the ache. Conversely, carrying anything heavy increases the pull.

If raising the arm increases the pain and tingling in the hand then we are probably talking about a thoracic outlet syndrome, rather than a slipped disc in the neck.

Another sign of a slipped disc is that
rotating your head to the side of the aching arm, and then looking up increases the symptoms; it
immediately produces pain and tingling, not just in the neck, but in the shoulder and down towards the hand too.

When this happens you must take it seriously. It's a
very painful condition and, if you neglect it, the chances of spinal
surgery are relatively high.

The arm
becomes numb, and may develop weakness. The triceps is the most commonly
affected muscle. Press ups will be difficult; the limb becomes lame.

Periodically a patient walks into the clinic with his hand on the head; the diagnosis is already made.

UPPER LIMB TENSION TEST (ULTT)

Your chiropractor will stretch
out first your good arm, and then the naughty arm. In the true slipped
disc arm pain, the naughty arm will feel very tight and painful in the
lower arm. This is a test you could do at home... but be careful, when
it's strongly positive it can be very painful and, injudiciously done,
could aggravate the condition:

Cervical compression tests

There are various procedures, placing axial compression on the head and neck in different positions, looking to provoke the pain in the arm.

A variation is Spurling's test. Does turning to the side of pain, and then looking up produce lower neck stabs, and more significantly, an ache or tingling in the arm?

Your chiropractor will test the reflexes,
look for sensory changes and search for weakness in the arm. This is a very painful condition and needs to be taken seriously, both by you, and by
those treating you.

Controversial, this may make me a few
enemies, if your chiropractor doesn't do a proper examination, and just
wants to click your neck then go elsewhere; or, for that matter, your medical doctor just
wants to give you
anti inflammatory drugs
without examining you, then I recommend you decline treatment, and look for someone who is thorough. This is not a condition to be treated by those who are out of
their depth, or want to take short cuts.

The most common muscle affected by slipped disc arm pain is the triceps which straightens the elbow. Try doing some pressups. Does the affected arm tire much more quickly?

Research
does not confirm that traction ON ITS OWN will relieve a slipped disc
in neck, or help reduce the pain and tingling in arms and hands, but my
experience is that as an adjunct to chiropractic care it is very
helpful. But that is just an opinion, based on my experience, and not
confirmed by research.
HOME TRACTION UNIT

PAIN AND TINGLING IN ARMS AND HANDS

One of the first nasty
signs of slipped disc in neck is various nerve-like symptoms that
radiate down your arm. Not that this necessarily implies a slipped disc
neck pain.

Cervical rib

So too a large cervical rib can cause pain and tingling in
arms and hands, mimicing a slipped disc arm pain condition. See in the
graphic below how the cervical rib passes through the interscalene
triangle, along with the brachial plexus and the Subclavian artery?

Your
chiropractor will have to work out what works best for your slipped
disc in neck. Usually a gentle cervical adjustment is in my book the
treatment of choice, but it has to be done very skillfully and
carefully.

And sometimes manipulation just doesn't seem to help,
and may even increase the pain. Then your chiropractor will have to try
this and that. Axial traction often helps, working on the scalene
muscles, ice, acupuncture, electrical modalities... this is a difficult
condition and you may well have to be patient. It will take at least six
weeks to heal.

SLIPPED DISC ARM PAIN CaseFile

Mr G is a 42 year old weight
lifter. He had an old lifting injury to his shoulder and neck. Suddenly,
two months previously, whilst doing a pull down, he developed severe
neck and arm pain... a separate page will be built with this case
history.
SLIPPED DISC IN NECK ... √

YOUR KIDS

SAFETY

GENERAL

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Mrs T looked like the leaning tower of Pisa; she had a slipped disc at L5 making her lean towards the opposite side. It's called the postero lateral disc hernia; she's much better after two weeks of treatment and will go back to work next week, part time. Lateral discs are more difficult; both take a minimum of six weeks to heal. In my opinion, antalgic patients need what I call exercising bed rest. Sit and it won't get better.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the groin pain, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your lower back is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her hip, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Hypermobility is more difficult that too stiff in my opinion. Chiropractic is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback
since working above his head. Trapped nerve tests are negative but he
has advanced degenerative joints of Luschka; after just two treatments
he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Interesting questions from visitors

CLS writes:

Greetings, Dr B.You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.

1. Shoulder

It's
probably temporary inflammation of the median nerve, but of course
could be worse... I'm afraid I don't think chiropractic has anything to
offer at this stage.

Once
everything has healed up, if you don't get the strength back, or your
fingers remain numb and tingly, then I'd consult a local chiro to see if
there is also a problem in your neck or the first rib.